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"返回基点"组合低温和正常热机器输液的人体捐赠肝脏
Otto B van Leeuwen1, Veerle A Lantinga1, Bianca Lascaris1
1Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Nature protocols
|February 26, 2025
概括
一个新的DHOPE-COR-NMP协议使用顺序机器输液来改善扩展标准供体 (ECD) 肝脏的保存. 这种方法最大限度地减少伤害,并允许评估可行性,可能增加捐赠肝脏利用率.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植免疫学 移植免疫学
- 器官的保存 器官的保存
背景情况:
- 由于供体器官短缺,需要使用扩展标准供体肝脏 (ECD),这些肝脏具有更高的移植后衰竭风险.
- 供体肝脏的传统静态冷藏有其局限性,特别是对于高危器官.
- 现场机器输液提供动态保存,以减轻与ECD肝移植相关的风险.
研究的目的:
- 描述一种结合双低温氧化机器输液 (DHOPE) 和正常热机器输液 (NMP) 的新型临床方案,以保存供体肝脏.
- 评估DHOPE-COR-NMP协议恢复线粒体功能的能力,并在保存和回暖过程中最大限度地减少损伤.
- 评估这种顺序输液策略的潜力,以提高ECD肝脏的利用率.
主要方法:
- "返回基地"协议涉及最初的静态冷藏,其次是连续的DHOPE,受控的氧化再加热 (COR) 和NMP.
- DHOPE (8-12°C) 保护肝脏,并减少缺血-再输血损伤.
- 在移植之前,NMP (35-37°C) 允许对肝脏和胆道活性的现场评估.
主要成果:
- 该DHOPE-COR-NMP协议有助于恢复线粒体功能.
- 这种序列性输液策略在过渡到NMP期间最大限度地减少了缺血-再输液损伤和温度变化引起的损伤.
- 在接受之前,NMP阶段使得捐赠肝脏的临界生存能力评估成为可能.
结论:
- 该DHOPE-COR-NMP协议提供了一个有希望的方法来减少与移植ECD肝脏相关的风险.
- 这种先进的保存技术可以显著提高边缘捐赠器官的利用率,解决关键器官短缺问题.
- 序列DHOPE和NMP代表了优化捐赠肝脏活力和移植结果的重大进展.
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